脑卒中患者步行时躯体运动的三维运动学研究

目的:通过对脑卒中患者躯体运动的三维运动学分析,比较分析偏瘫步态躯体运动变化与其步行能力(步速)之间的关系,探讨影响偏瘫患者步行能力恢复的量化指标。方法:选择首次脑卒中后可以独立步行10m以上的偏瘫患者39例,采用远红外线三维步态分析系统进行步态检测与分析,对偏瘫步态躯体的运动学参数与其步行能力(步速)进行相关分析。结果:脑卒中患者的步行能力与骨盆旋转运动之间的相关有显著性意义(r=-0.396.P<0.05);其步行能力与躯体侧方运动呈负相关,而与其躯体垂直运动呈正相关(r=-0.755,P<0.01;r=0.534,P<0.01),步行能力与Barthel指数正相关(r=0.475,P<0.01)。结论:脑卒中患者躯体和骨盆运动障碍是影响步态恢复的重要因素,提示躯体的协调性训练和骨盆的控制性训练对改善脑卒中偏瘫患者步行能力具有积极的作用。

Three-dimensional kinematic study of the trunk movements during walking in hemiplegic gait of stroke

Objective:To assess the relationship between the trunk and pelvis movements and walking ability (velocity) by analyzing the three-dimensional kinematic study of the trunk movements in stroke patients. Method:39 subjects with a chronic hemiplegia due to stroke, who could walk at least 10m independently without a walking aids were recruited. Pearson' s correlation was used to assess the relationship between the trunk movements parameters and walking ability (velocity). The significance of the correlation was assessed by comparison with the sample correlation coefficient. Result:The correlation between walking ability and pelvic rotation showed significant relationships (P<0.05).The correlation between walking ability and the trunk movements showed significant relationships with lateral and vertical movements (P<0.01).The correlation between walking ability and ADL showed significant relationships(P<0.01). Conclusion: The movements obstacle of the trunk and pelvis are important factors of influencing the restoration of walking ability in stroke patients. Gait analysis can be of importance in documenting abnormalities and determining the effects of therapeutic modalities.